When it comes to weight loss medications, Semaglutide (Wegovy) and Tirzepatide (Mounjaro) are two of the most popular options available. These medications are game-changers in the world of weight management, offering hope to those struggling with obesity and related health issues. But how do you know which one is right for you? Let’s explore the differences and similarities between these two medications to help you make an informed decision.

Mechanisms of action

Semaglutide

Semaglutide is a GLP-1 receptor agonist. This means it mimics the action of glucagon-like peptide-1 (GLP-1), a hormone naturally produced in the body that plays a crucial role in regulating blood sugar levels. Semaglutide works by:

• Increasing Insulin Secretion: It activates GLP-1 receptors on pancreatic beta cells, stimulating insulin release in response to high blood sugar levels.
• Decreasing Glucagon Secretion: It suppresses glucagon, a hormone that raises blood sugar levels, from pancreatic alpha cells.
• Delaying Gastric Emptying: It slows down the rate at which your stomach empties itself, leading to a slower and more gradual absorption of glucose in your bloodstream.
• Appetite Suppression: By helping your body feel full faster, it influences areas in the brain that control appetite, leading to reduced calorie intake and potential weight loss.

Tirzepatide

Tirzepatide is a dual receptor agonist, targeting both GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptors. This dual action makes it unique and potentially more effective. Here’s how Tirzepatide works:

• Enhanced Insulin Secretion: By acting on both GIP and GLP-1 receptors, Tirzepatide has a more comprehensive effect on stimulating insulin secretion than GLP-1 agonists alone.
• Inhibition of Glucagon: Similar to Semaglutide, it suppresses the release of glucagon, a hormone that raises blood sugar levels, from pancreatic alpha cells.
• Delayed Gastric Emptying and Appetite Control: It shares these effects with Semaglutide, potentially leading to greater efficacy in reducing blood sugar and aiding in weight loss.
• Additional GIP Effects: The GIP component of Tirzepatide has additional effects on energy expenditure and fat metabolism, although the full range of its actions is still being explored.

Results from clinical trials

Clinical trials provide valuable insights into how effective these medications are in real-world settings. The most notable study comparing Tirzepatide and Semaglutide is the Phase 3 SURPASS-2 trial. Here are the key findings from this and other relevant trials.

SURPASS-2 clinical trial

This was a 40-week Phase 3 clinical trial with 1,879 participants, all of whom had type 2 diabetes inadequately controlled with metformin alone. Tirzepatide at 5 mg, 10 mg, and 15 mg doses was compared to Semaglutide at a 1 mg dose.

Participants taking Tirzepatide experienced a reduction in hemoglobin A1c by 2-2.3%, whereas those on Semaglutide saw a reduction of 1.9%. Furthermore, Tirzepatide resulted in an average weight loss of 17 lbs to 25 lbs, while Semaglutide led to an average weight loss of 13 lbs. The study showed that higher doses of Tirzepatide were more effective in achieving greater weight loss compared to Semaglutide.

STEP clinical trials

These trials focused on the weight loss results of Semaglutide in non-diabetic obese individuals. The STEP 1 trial demonstrated that a 2.4 mg dose of Semaglutide resulted in an average weight loss of 14.9% of body weight over 68 weeks, significantly higher than the placebo group.

Cost considerations

Both Semaglutide and Tirzepatide can be costly, with prices ranging from $300 to $11,000 per month. The cost can vary based on dosage and your specific treatment plan. It’s important to consider these expenses and discuss them with your healthcare provider to find the most cost-effective option for your needs.

Potential side effects

Common side effects include nausea, vomiting, diarrhea, abdominal pain, and constipation. These symptoms are usually mild and tend to decrease over time. Other potential side effects include appetite changes, hypoglycemia (when used with other diabetes medications), pancreatitis, vision changes, increased heart rate, and a potential risk of thyroid tumors.

Tirzepatide can also cause nausea, vomiting, diarrhea, abdominal pain, and constipation. It also shares the risks of hypoglycemia, pancreatitis, and thyroid tumors. Additionally, some patients might experience injection site reactions, such as blistering or itchiness. Overall, the side effects of Semaglutide and Tirzepatide are fairly comparable to each other.

Best practices for using Semaglutide or Tirzepatide:

• Drink plenty of water to prevent constipation caused by slowed gastric emptying.
• Take a GLP-1 support supplement, such as Korbiotic offered by Genesis Lifestyle Medicine, to support GLP-1 function and aid in brain, bone, muscle, and skin health.
• Adopt a high-protein diet to boost metabolism and maintain muscle mass during weight loss. Foods low in sugar spikes, such as meats and vegetables, also help manage blood sugar levels and improve medication efficacy.

Choosing the right medication for you

Deciding between Semaglutide and Tirzepatide depends on your individual health goals and how your body responds to these medications. Tirzepatide has shown increased weight loss over time, which might make it a preferable option for some patients. Often, treatment might start with Semaglutide and switch to Tirzepatide if weight loss plateaus.

If you’re struggling with weight loss and need expert guidance, book a consultation with Genesis Lifestyle Medicine. With 19 locations across the U.S. and a nationwide telehealth service, we’re here to help you take control of your weight and achieve your health goals.